Prevalence Of Ureaplasma Urealyticum And Mycoplasma Hominis In Women With Chronic Urinary Symptoms

Main Category: Urology / Nephrology
Also Included In: Women's Health / Gynecology
Article Date: 03 Aug 2009 - 1:00 PDT

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UroToday.com - Ureaplasma urealyticum and Mycoplasma Hominis are members of a unique group of microorganisms commonly identified in the genital tract of women. With the onset of sexual intercourse the prevalence of Mycoplasma increases dramatically an isolation is strongly dependent on the number of sexual partners. Convincing evidence of an infection caused by genital Mycoplasma is not easy, because they usually are not isolated in pure culture, making the evaluation even more difficult.

Dr. Stavroula Baka and colleagues from Athens, Greece evaluated the prevalence of U. urealyticum and M hominis in women presenting with chronic urinary symptoms, and the subsequent improvement, if any, of symptom severity and urinary frequency after appropriate therapy targeting these microorganisms. The 153 patients who completed the study had symptoms including dysuria, pelvic pain, urgency, frequency, and dyspareunia. They had either failed a course of antimicrobial therapy or had negative routine cultures. Urine samples (midstream and catheter specimens), and urethral, vaginal, and cervical swabs were obtained. U. urealyticum was detected from 1 or more sites in 52.9% and M. hominis was detected in 5 women, all of whom were positive for U. urealyticum. In 82.3% of patients positive for U. urealyticum, other pathogens were also identified. A single-dose regimen of 1 gram azithromycin was given to all culture positive patients and recommended for their sexual partner. Those with a positive culture one month after therapy (4.9%) were successfully treated with 7 days of doxycycline 100mg twice daily.

Significant improvement was observed in all symptoms. When the mean difference in the urinary symptom scores before and after treatment in women with positive cultures for Mycoplasma only was compared with those from women with Mycoplasma and other organisms as well, dysuria, dyspareunia, urinary urgency, and urinary frequency had improved significantly, while there was no difference in pelvic pain between the groups.

The authors conclude that the significant improvement noted in all symptom scores after treatment in women with positive cultures for U. urealyticum and M. hominis suggests that these pathogens might have been involved in the etiology of chronic urinary symptoms experienced in this group of patients.

Baka S, Kouskouni E, Antonopoulou S, Sioutis D, Papakonstantinou M, Hassiakos D, Logothetis E, Liapis A
Urology. 2009 Jul;74(1):62-6
10.1016/j.urology.2009.02.014

Written by UroToday.com Contributing Editor Philip M. Hanno, MD, MPH

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